Ho A M-H, Nelson E A S, Walker D G
Department of Anaesthesia and Intensive Care, The Chinese University of Hong Kong, Hong Kong SAR, PRC.
Arch Dis Child. 2008 Jan;93(1):52-8. doi: 10.1136/adc.2007.117879. Epub 2007 Sep 12.
To perform an economic analysis of government-funded universal rotavirus vaccination in Hong Kong from the government's perspective.
A Markov model of costs and effects (disability averted) associated with universal vaccination was compared with no vaccination. In both strategies, newborns were studied until 5 years of age or until they died, using cost, probability and utility data from the literature. The potential cost savings and cost effectiveness of vaccination were calculated and their sensitivities to changes in vaccine and health care costs, presumed decline in vaccine efficacy over time, and the use of discounting and age weights were determined.
Depending on assumptions, the new rotavirus vaccines would be cost saving to the Hong Kong Government if they cost less than US$40-92 per course. Higher vaccine costs would quickly lead to an incremental cost-effectiveness ratio exceeding that of the gross national product per capita if the mortality rate of rotavirus gastroenteritis remained at zero.
Based on 2002 demographic, cost and morbidity data and reasonable uncertainty estimates of these variables, a universal rotavirus vaccination programme paid for by the Hong Kong Government is cost neutral at a per course vaccine cost of US$40-92. For a fixed vaccine cost, the potential savings and cost effectiveness of the vaccine increase with higher estimated health care costs and vice versa.
从政府角度对香港政府资助的轮状病毒普遍接种疫苗进行经济分析。
将与普遍接种疫苗相关的成本和效果（避免残疾）的马尔可夫模型与未接种疫苗的情况进行比较。在这两种策略中，对新生儿进行研究直至5岁或死亡，使用文献中的成本、概率和效用数据。计算接种疫苗的潜在成本节约和成本效益，并确定其对疫苗和医疗保健成本变化、假定疫苗效力随时间下降以及贴现和年龄权重使用的敏感性。
根据假设，如果每疗程轮状病毒疫苗成本低于40 - 92美元，那么对香港政府而言，新的轮状病毒疫苗将节省成本。如果轮状病毒肠胃炎死亡率保持为零，更高的疫苗成本将迅速导致增量成本效益比超过人均国民生产总值。
基于2002年的人口、成本和发病率数据以及对这些变量的合理不确定性估计，由香港政府支付的轮状病毒普遍接种疫苗计划在每疗程疫苗成本为40 - 92美元时成本持平。对于固定的疫苗成本，疫苗的潜在节省和成本效益随着估计的医疗保健成本增加而增加，反之亦然。
